Beyond SIBO: If Your "Gut Issues" Are Actually Mechanical

[hawkmoon]

Hey all, I wanted to share an update on my abdominal distention issues, as I know many of us in the community go down the "digestive health" rabbit hole and stay there for years without full resolution. ​

If you’ve been chasing SIBO protocols, elimination diets, and enzymes but still look six months pregnant despite a low body fat percentage, this might be the missing piece.​

The Background: The SIBO/Diastasis Trap​

My journey started with a confirmed case of SIBO (Small Intestinal Bacterial Overgrowth) and Diastasis Recti (abdominal separation). Naturally, I focused entirely on the internal: fixing the microbiome, clearing the overgrowth, and hoping the distention would vanish once the "gas" was gone.
However, even after my appetite returned, the gas pain subsided, and my digestion felt "normal," the distention remained.

The Red Flags: It’s Not Just Digestion​

I realized my symptoms didn't fit the standard SIBO profile anymore:

• The Morning Look: Most SIBO sufferers wake up flat and bloat as the day progresses. I was waking up with a distended, hard belly. 24/7 - no changes.
• Lack of Pain: I had no significant gas or GI distress, yet the protrusion was constant. After treating SIBO for a few rounds and doing an elimination diet most food issues dissipated, and there is no "gas pressure" discomfort.
• The Asthma Connection: Having asthma my whole life likely forced me into a "belly breathing" pattern because my diaphragm is always slightly contracted and lowered, which I've now learned plays a massive role in how the torso handles pressure. This caused my ribs to stiffen.

The Discovery: Abdomino-Phrenic Dyssynergia (APD)​

I’ve recently pivoted my focus to APD. Essentially, APD is a coordination failure: the diaphragm pushes down (as if to inhale), but instead of the abdominal wall contracting to stabilize the pressure, the abs relax and protrude.
It’s a mechanical/neurological "glitch" rather than a fermentation issue.

The "Inversion Test" that changed my perspective:
I found that when I lie on my back with my feet up against the wall (inverted), my belly immediately softens and flattens (somewhat). The "bloat" fades because gravity and position allow the diaphragm to reset and the viscera to shift. However, the second I stand up, the abdominal wall hardens and pushes out again.
This confirmed it wasn't "air" or "gas"—it was a failure of my nervous system to manage intra-abdominal pressure while upright.

Shifting the Protocol​

If you are struggling with "permanent bloat" despite a clean diet, consider the mechanical aspect:

1. Stop chasing only the gut: If the antimicrobials haven't worked after multiple rounds, look at your breathing mechanics. Can you breathe into your upper back? Are your ribs hinging properly?
2. The Diaphragm/TVA Relationship: My asthma and Diastasis Recti created a perfect storm where my diaphragm is "stuck" in a low position, and my transverse abdominis (TVA) has forgotten how to provide opposing tension.
3. Recovery: I’m now focusing on respiratory retraining and "visceral" cues to teach the diaphragm to ascent during exhalation and the abdominal wall to support the load. Using BPC and KPV orally as well to help soften and heal what I can.

We spend so much time on macros and supplements, but for those of us with years of lifting and potentially dysfunctional breathing (like asthma), the "gut" issue might actually be a structural/neurological one.
Has anyone else here successfully navigated APD or Diaphragmatic retraining? I’m curious to hear if this "hard belly" distention resonates with anyone else who thought they just had stubborn SIBO.

Excellent video on some rehab exercises:

 

[AllOkJumpmaster]

I appreciate all of your contributions around here man, always level headed and focused on helping others through your experiences. I said this on 55's member of the quarter announcement post also, you guys are an anchor around here, and keep this place alive and well in a world where forums are dead.

 

[hawkmoon]

I appreciate all of your contributions around here man, always level headed and focused on helping others through your experiences. I said this on 55's member of the quarter announcement post also, you guys are an anchor around here, and keep this place alive and well in a world where forums are dead.

Thanks for the kind words. Information and experience is worthless if not shared IMHO.

 

[specter]

This is going in the bookmarks..

 

[jl9987]

I'm down this rabbit hole to.

I was told it's cos my ribs are flared and I'm very forward in space, so that causes by guts to push forward. I need to focus on 360 rib expansion more when breathing and do some exercises where I get breath into my posterior back to open up space.

 

[d4ve]

Very real. I went through a gut protocol with Austin Stout, which absolutely did help my gut issues contributing to distention and fatigue. I also had a hernia operation about a year and a half ago, which likewise helped.

But I still swing between significant distention and a flat stomach based purely on orthopedic issues - pelvis position and rib cage mobility, basically.

My wife Dani has been helping me a ton with this and will hopefully put out a lot more content about it soon. If I had to simplify it with my limited understanding, though - if your ribs are flared, your pelvis is constantly tilted forward, and your center of mass is super "forward" (common for a lot of lifters, especially those of us who spent years bracing hard in powerlifting), you're effectively both widening your waist and closing down the spaces through which your diaphragm and gut contents need to move. The effects in a nutshell - upregulated sympathetic activity, constipation, abdominal water retention, maybe even suppressed insulin sensitivity stemming from poor gut motility. If it persists it'll also take a toll on training quality - harder to activate lats, quads, glutes, etc.

Aside from some breathing drills and corrective exercises, the biggest "fixes" I've done thus far are training changes - basically overhauls in technique on leg and back training. The kind that make you feel like you have to use bitch weight (at first, at least), but that keep my ribs and pelvis in good positions. Thankfully these changes have also kind of unlocked new gains, I've just had to put ego to the side.

If you work a desk job and sit all day, postural adjustments can help big time, too. It's kind of silly to think that a few minutes of correctives 1-2x per day are going to make major changes when you're contributing to the problem with the way you sit 8+ hours per day.

 

[Duke309]

Very real. I went through a gut protocol with Austin Stout, which absolutely did help my gut issues contributing to distention and fatigue. I also had a hernia operation about a year and a half ago, which likewise helped.

But I still swing between significant distention and a flat stomach based purely on orthopedic issues - pelvis position and rib cage mobility, basically.

My wife Dani has been helping me a ton with this and will hopefully put out a lot more content about it soon. If I had to simplify it with my limited understanding, though - if your ribs are flared, your pelvis is constantly tilted forward, and your center of mass is super "forward" (common for a lot of lifters, especially those of us who spent years bracing hard in powerlifting), you're effectively both widening your waist and closing down the spaces through which your diaphragm and gut contents need to move. The effects in a nutshell - upregulated sympathetic activity, constipation, abdominal water retention, maybe even suppressed insulin sensitivity stemming from poor gut motility. If it persists it'll also take a toll on training quality - harder to activate lats, quads, glutes, etc.

Aside from some breathing drills and corrective exercises, the biggest "fixes" I've done thus far are training changes - basically overhauls in technique on leg and back training. The kind that make you feel like you have to use bitch weight (at first, at least), but that keep my ribs and pelvis in good positions. Thankfully these changes have also kind of unlocked new gains, I've just had to put ego to the side.

If you work a desk job and sit all day, postural adjustments can help big time, too. It's kind of silly to think that a few minutes of correctives 1-2x per day are going to make major changes when you're contributing to the problem with the way you sit 8+ hours per day.

so basically stacking your ribcage and pelvis instead of having an open scissor at the front?

 

[TheOtherOne55]

This is great info @hawkmoon. I swear me and you are the same person.
Justin and i have spent hoursss discussing what and how we are attacking issues, brainstorming different causes, trying protocols, etc.
I thought it was hernias. Not really. I thought it was SIBO. Not really. The reality is, my posture and the way i stack my ribs and pelvis have changed, as well as my breathing. And me thinking, "oh just doing vacuums multipel times a day will fix it," is naive. I have turned into a hips forward belly breather and im trying my hardest to find the best way to correct this. Whats weird is that yes i have a wide waist. Nothing i can do about that, but the side poses is where im exposed with lower abdominal distention. Seeing you do deep dives into this is great and makes me think I CAN fix this shit lol or at least help it.

 

[d4ve]

This is great info @hawkmoon. I swear me and you are the same person.
Justin and i have spent hoursss discussing what and how we are attacking issues, brainstorming different causes, trying protocols, etc.
I thought it was hernias. Not really. I thought it was SIBO. Not really. The reality is, my posture and the way i stack my ribs and pelvis have changed, as well as my breathing. And me thinking, "oh just doing vacuums multipel times a day will fix it," is naive. I have turned into a hips forward belly breather and im trying my hardest to find the best way to correct this. Whats weird is that yes i have a wide waist. Nothing i can do about that, but the side poses is where im exposed with lower abdominal distention. Seeing you do deep dives into this is great and makes me think I CAN fix this shit lol or at least help it.

Probably not just the side poses. I have a fairly wide waist, too, but it looks so much different in front poses on "good posture days" vs. "bad posture days," lol.

Dani said it yesterday in a way that should really click for anyone who's added a lot of muscle - You have to relearn how to move when you get a different body...which, if you've added 50-100 lbs. of tissue, you basically have.

 

[w4rr10r]

Very real. I went through a gut protocol with Austin Stout, which absolutely did help my gut issues contributing to distention and fatigue. I also had a hernia operation about a year and a half ago, which likewise helped.

But I still swing between significant distention and a flat stomach based purely on orthopedic issues - pelvis position and rib cage mobility, basically.

My wife Dani has been helping me a ton with this and will hopefully put out a lot more content about it soon. If I had to simplify it with my limited understanding, though - if your ribs are flared, your pelvis is constantly tilted forward, and your center of mass is super "forward" (common for a lot of lifters, especially those of us who spent years bracing hard in powerlifting), you're effectively both widening your waist and closing down the spaces through which your diaphragm and gut contents need to move. The effects in a nutshell - upregulated sympathetic activity, constipation, abdominal water retention, maybe even suppressed insulin sensitivity stemming from poor gut motility. If it persists it'll also take a toll on training quality - harder to activate lats, quads, glutes, etc.

Aside from some breathing drills and corrective exercises, the biggest "fixes" I've done thus far are training changes - basically overhauls in technique on leg and back training. The kind that make you feel like you have to use bitch weight (at first, at least), but that keep my ribs and pelvis in good positions. Thankfully these changes have also kind of unlocked new gains, I've just had to put ego to the side.

If you work a desk job and sit all day, postural adjustments can help big time, too. It's kind of silly to think that a few minutes of correctives 1-2x per day are going to make major changes when you're contributing to the problem with the way you sit 8+ hours per day.

I struggle with this same thing which also restricts my breathing, makes it tough to relax, and contributes to chronic lower back pain. I'd definitely be interested in seeing more content about this.

 

[Anabolix8]

This is actually a really solid breakdown and something a lot of guys overlook when they go down the endless SIBO / digestion rabbit hole.

What you described with waking up already distended, no real gas pressure, and the stomach flattening somewhat when lying or inverted is a pretty classic sign that pressure management and breathing mechanics are involved, not just fermentation in the gut. Years of lifting heavy combined with things like asthma or chronic mouth breathing can absolutely lock the diaphragm down and the TVA stops doing its job.

A lot of people underestimate how much rib position, diaphragm function, and intra-abdominal pressure control affects the way the abdomen presents. If the diaphragm stays depressed and the abs don’t reflexively brace, the contents basically push outward all day even when digestion itself is fine.

Your shift toward diaphragmatic retraining and rib mobility work makes sense. I’ve seen quite a few guys improve their “perma-bloat” once they started working on breathing mechanics, TVA activation, and restoring that diaphragm/ab wall coordination rather than just running endless gut protocols.

Definitely interested to see how things progress for you with that approach.

Hey all, I wanted to share an update on my abdominal distention issues, as I know many of us in the community go down the "digestive health" rabbit hole and stay there for years without full resolution.

If you’ve been chasing SIBO protocols, elimination diets, and enzymes but still look six months pregnant despite a low body fat percentage, this might be the missing piece.​

The Background: The SIBO/Diastasis Trap​

My journey started with a confirmed case of SIBO (Small Intestinal Bacterial Overgrowth) and Diastasis Recti (abdominal separation). Naturally, I focused entirely on the internal: fixing the microbiome, clearing the overgrowth, and hoping the distention would vanish once the "gas" was gone.
However, even after my appetite returned, the gas pain subsided, and my digestion felt "normal," the distention remained.

The Red Flags: It’s Not Just Digestion​

I realized my symptoms didn't fit the standard SIBO profile anymore:

• The Morning Look: Most SIBO sufferers wake up flat and bloat as the day progresses. I was waking up with a distended, hard belly. 24/7 - no changes.
• Lack of Pain: I had no significant gas or GI distress, yet the protrusion was constant. After treating SIBO for a few rounds and doing an elimination diet most food issues dissipated, and there is no "gas pressure" discomfort.
• The Asthma Connection: Having asthma my whole life likely forced me into a "belly breathing" pattern because my diaphragm is always slightly contracted and lowered, which I've now learned plays a massive role in how the torso handles pressure. This caused my ribs to stiffen.

The Discovery: Abdomino-Phrenic Dyssynergia (APD)​

I’ve recently pivoted my focus to APD. Essentially, APD is a coordination failure: the diaphragm pushes down (as if to inhale), but instead of the abdominal wall contracting to stabilize the pressure, the abs relax and protrude.
It’s a mechanical/neurological "glitch" rather than a fermentation issue.

The "Inversion Test" that changed my perspective:
I found that when I lie on my back with my feet up against the wall (inverted), my belly immediately softens and flattens (somewhat). The "bloat" fades because gravity and position allow the diaphragm to reset and the viscera to shift. However, the second I stand up, the abdominal wall hardens and pushes out again.
This confirmed it wasn't "air" or "gas"—it was a failure of my nervous system to manage intra-abdominal pressure while upright.

Shifting the Protocol​

If you are struggling with "permanent bloat" despite a clean diet, consider the mechanical aspect:

1. Stop chasing only the gut: If the antimicrobials haven't worked after multiple rounds, look at your breathing mechanics. Can you breathe into your upper back? Are your ribs hinging properly?
2. The Diaphragm/TVA Relationship: My asthma and Diastasis Recti created a perfect storm where my diaphragm is "stuck" in a low position, and my transverse abdominis (TVA) has forgotten how to provide opposing tension.
3. Recovery: I’m now focusing on respiratory retraining and "visceral" cues to teach the diaphragm to ascent during exhalation and the abdominal wall to support the load. Using BPC and KPV orally as well to help soften and heal what I can.

We spend so much time on macros and supplements, but for those of us with years of lifting and potentially dysfunctional breathing (like asthma), the "gut" issue might actually be a structural/neurological one.
Has anyone else here successfully navigated APD or Diaphragmatic retraining? I’m curious to hear if this "hard belly" distention resonates with anyone else who thought they just had stubborn SIBO.

Excellent video on some rehab exercises:

 

[Splitzz]

Going to incorporate this into my routine very soon. My lower abdomen extension has been bothering me for years. Vacuum haven’t changed anything at all. Gives me hope again lol. It’s not horrible but in my eyes it is

 

[Heady Muscle 2]

Thanks for the kind words. Information and experience is worthless if not shared IMHO.

Well said! Thank you for sharing this.